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[Hannah50]

I recently upped my evorel to 100mcg by cutting some 50mcg patches in half to add to my 75mcg dose - I know I should have consulted the GP but I wanted to try it and see if it helps before getting my prescription changed - so far so good (I know that's the max safe dose). I am due to have my mirena changed this year (well into 5th year so getting low) but now I wonder if I might actually need more progesterone until that happens? Would 100mg daily vaginal utrogestan be enough to cover this higher dose of evorel, as I have some I could use but would prefer to avoid taking orally due to previous effect on mood. Are there any side effects to using utrogestan vaginally? My GP has previously said wait until full 5 years are up before changing mirena, but that was when I was on 75mg evorel, so I'll ask again now.  Thanks

[sheila99]

They've changed the guidelines recently, mirena good for 4 years instead of 5, utro 300mg sequi or 200mg conti. Yes, you can get side effects from vaginal utro but most people are OK on it (I'm one who isn't).

[bombsh3ll]

There's no need to use additional progesterone with a mirena.

As far as I am aware the UK guidance is still 5 years for endometrial protection. This may not be the same as the manufacturers licence, which was 4 years unless this has changed recently.

After that it should ideally be replaced as soon as possible, but doesn't require a blue light ambulance.

Unofficially, during the pandemic thousands of women worldwide with an IUS went well beyond 5 years as they couldn't get it changed, and continued to use estrogen. There is observational evidence from this population that up to 7 years showed no endometrial thickening.

However at this point it is not enough to change usual practice but is reassuring in the event that someone has gone over 5 years.

[Hannah50]

That's reassuring to know, thanks for the answers